Cuspid and first bi-cuspid bite retainer for sleep apnea

ABSTRACT

A retainer with a block extending downwards from an otherwise generally flat surface is disclosed. The block corresponds to a region of one or more of the cuspids or pre-molars. A side block or other device on the upper retainer also abuts a wing or other abutment device of a lower retainer, causing the lower jaw to be pushed forward relative to the upper jaw and resting position (regular organic closing position) of the upper and lower jaw together. Thus, the upper teeth are pushed forward and a space is created between the teeth behind the (lower) block preventing an apnea during sleep.

FIELD OF THE DISCLOSED TECHNOLOGY

The disclosed technology relates generally to mouth retainers, and morespecifically to one with a bite region at the cuspid and firstbi-cuspid.

BACKGROUND OF THE DISCLOSED TECHNOLOGY

There are three forms of sleep apnea: central (CSA), obstructive (OSA),and complex or mixed sleep apnea (i.e., a combination of central andobstructive) constituting 0.4%, 84% and 15% of cases, respectively. InCSA, breathing is interrupted by a lack of respiratory effort; in OSA,breathing is interrupted by a physical block to airflow despiterespiratory effort, and snoring is common. Referring now to OSA, morethan 12 million American adults have obstructive sleep apnea. It is adisorder in which breathing is repeatedly, but briefly, interruptedduring sleep. Obstructive sleep apnea occurs when the muscles in theback of the throat fail to keep the airway open, making it difficult tobreathe. It is more common in people who are overweight, but it canaffect anyone. For example, some small children may have obstructivesleep apnea due to enlarged tonsil tissue in their throats. For thosewith OSA, the airway collapses or becomes blocked during sleep. Thiscauses shallow breathing, or pauses in breathing, which leads tofragmented sleep and low blood oxygen levels. OSA is commonlyaccompanied by snoring, as well. This is referred to as Upper AirwayRestrictive Syndrome (UARS) and may also derive from medical conditionssuch as deviated septum, large turbinates, narrow palate, long softpalate etc. This condition is considered to be the same as OSA and isdiagnosed and treated similarly. Sleep bruxism is another sleep disorderthat occurs concurrently with OSA in a majority of patients. This isforceful side to side, front to back or vertical clenching andunclenching of the mandible. This can occur in all age groups and occursin the general population at a frequency of between 8% and 26%.

Some patients with obstructive or other types of sleep apnea may benefitfrom surgery. The type of surgery depends on the cause of the sleepapnea. Examples for common types of surgical procedures for sleep apneainclude removing the tonsils and adenoids, if these organs are blockingthe airway. This can be especially helpful in the case of children. Inadvanced, non-responsive cases, the mandible may be broken andlengthened, to move the tongue out of the throat region. Another surgeryinvolves placing a small hole and tube in the windpipe, causing airflowthrough the tube into the lungs. This is carried out in severe cases ofsleep apnea. In still other cases, the uvula (the tissue that hangs downin the middle of the back of the throat), and part of the roof of themouth at the back of the throat may be removed.

Another common treatment for sleep apnea, which does not requireinvasive surgery, is called continuous positive airway pressure (CPAP).In this treatment, the patient wears a special mask over nose and mouth(or inserts into the nose) while sleeping. The mask keeps the wearer'sairway open by increasing the air pressure breathed in by the wearer.However, such masks cover a large portion of the face and head, aregenerally uncomfortable, and may leak or can fall off, thus reducingeffectiveness. They do not treat sleep bruxism.

Still further, devices of the prior art have been designed to aid inobstructive sleep apnea problems. U.S. Pat. No. 5,427,117, issued toThornton et al., discloses a dental device which includes adjustableupper and lower arch trays. The device has an upper arch and lower archwith an adjustable post that extends from the upper arch and contactsthe lower arch, so that the user's lower jaw is extended forward withrespect to the upper. The post shown in these references is shaped toengage with the lower arch, so that the user's mouth cannot be openedmore than a predetermined amount while the post is engaged.

Still another device has been described in U.S. Pat. No. 5,829,441issued to Kidd et al., which discloses a mandible extension dentaldevice including adjustable upper and lower arch trays. Each upper andlower arch tray includes a U-shaped tray body attached to the upper andlower teeth. The device is adjusted to selectively cause extension ofthe user's lower jaw when the mouth is closed. The upper and lower traysdovetail with a depending hook located in the front of the device.

U.S. Pat. No. 6,766,802, issued to Keropian et al., discloses anappliance that covers the inside of the upper teeth only with an openpalate similar to an upper orthodontic retainer. This device further hasa retainer wire to hold the anterior teeth in place, or to move suchteeth backwards, and a raised strip that extends from an incisor tip(biting edge) of central incisors to separate the posterior teeth andhold the tongue down.

Another device, the ALF (Advanced Lightwire Functionals) appliance is acemented expansion appliance for orthodontic treatment. These devicesare cemented with bands around the first molars with a wire custom bentto fit the teeth. Activation of the wire expands a plate. Another deviceis to a type of removable retainer that actively moves the teeth forfinal positioning. This appliance completely covers the teeth and doesnot have a definitive bite.

Thus, while there are many different ways of attempting to alleviateproblems associated with OSA, there is still room for improvement. Thereis a need in the field to find devices which are least obtrusive, morecomfortable, easy to use, durable, and most effective.

SUMMARY OF THE DISCLOSED TECHNOLOGY

In an embodiment of the disclosed technology, an upper and lowerretainer (defined as “a device which snugly abuts teeth and can beremoved therefrom”) are used. An upper retainer is adapted for abutmentagainst upper teeth, the upper retainer having a generally flat andelongated lower surface adapted to cover molars. The upper retainerfurther has lower blocks extending further downwards than the generallyflat and elongated lower surface, forming its own lowest surface of thedevice and adapted to cover canine and first bicuspid teeth.

The lower retainer is adapted for (defined as “shaped in a way that theforegoing function is carried out readily and easily with the device”)abutment against lower teeth, the lower retainer having a generally flatand elongated upper surface adapted to cover one or more of, or all ofcanine, cuspid, first and second bicuspid, and molars. Wings can extendfrom the lower retainer towards the upper retainer adapted to abutrespective side blocks on exterior sides of the upper retainer.

The upper retainer and lower retainer can abut each other by way ofcontact between the lower blocks and the generally flat and elongatedupper surface. A space can be formed between the upper retainer and thelower retainer at a region corresponding to the molars and the secondbicuspid. The lower retainer further can have wings extendingperpendicularly to the generally flat and elongated upper surface. Thewings can abut respective side blocks jutting outwards from the upperretainer's side walls. The wings can have a front side perpendicular tothe generally flat and elongated lower surface.

A wire on each of the upper retainer and the lower retainer covers atleast the incisors, in embodiments of the disclosed technology. Thiswire connects left and right elongated regions (with flat upper or lowersides) together.

Described another way, the upper retainer has a metal wire adapted tocover incisors and connect left and right sides of the retainer. Eachleft and right side of the retainer has two generally flat regions on abottom side. A rear region is adapted to cover at least molars and afront region is adapted to cover at least the first bicuspid and part ofthe cuspid, the front region extending lower from the teeth than therear region. The front region and rear region can be separated at avertically extending region which is perpendicular or generally so tothe front and rear region. A side block, located at each rear region,has a flat front side extending outwards from the rear region. The frontregion has a generally flat lower surface, the generally flat lowersurface forming a lowest side of the retainer for upper teeth.

Described yet another way, a retainer system with abutting upperretainer and lower retainer has a spaced apart region between areas ofthe upper retainer and the lower retainer corresponding to molars of theteeth that the retainers are adapted to cover. The retainer system canhave contact points between the upper retainer and the lower retainer atregions corresponding to a first bi-cuspid of the upper teeth.

The spaced apart region further, in embodiments, has a regioncorresponding to a second bi-cuspid. The contact points can have aregion corresponding to the cuspids. The lower retainer can havevertically extending wings. The upper retainer can have blocks extendingoutwards at a spaced apart region, each with a generally flat frontsurface. Each wing of the wings can abut a generally flat front surfaceof a block of the respective blocks. Contact points (which contact thelower retainer) of the upper retainer are at a lowest most extremity ofthe upper retainer at a block extending downwards further than a rest ofthe upper retainer. These contact points of the lower retainer can be onone of two generally flat elongated surfaces extending from a wire to anarea corresponding to a molar.

Embodiments described with reference to the device of the disclosedtechnology are equally applicable to methods of use thereof.

“Substantially,” “substantially shown,” “and “generally” for purposes ofthis specification, are defined as “at least 90%,” or as otherwiseindicated. Any device can “comprise” or “consist of” the devicesmentioned there-in, as limited by the claims. Any device recited in thespecification is within an acceptable tolerance level known in the art,exactly as defined, and/or substantially as described.

It should be understood that the use of “and/or” is defined inclusivelysuch that the term “a and/or b” should be read to include the sets: “aand b,” “a or b,” “a,” “b.”

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a lower perspective view of an upper retainer of anembodiment of the disclosed technology.

FIG. 2 shows a bottom plan view of the upper retainer of FIG. 1.

FIG. 3 shows a front elevation view of the upper retainer of FIG. 1.

FIG. 4 shows a rear elevation view of the upper retainer of FIG. 1.

FIG. 5 shows a side elevation view of the upper retainer of FIG. 1.

FIG. 6 shows an upper perspective view of a lower retainer of anembodiment of the disclosed technology.

FIG. 7 shows a top plan view of the lower retainer of FIG. 6.

FIG. 8 shows a front elevation view of the lower retainer of FIG. 6.

FIG. 9 shows a rear elevation view of the lower retainer of FIG. 6.

FIG. 10 shows a side elevation view of the lower retainer of FIG. 6.

FIG. 11 shows the upper and lower retainers aligned for abutment againsteach other.

FIG. 12 shows the upper and lower retainers abutted against each other.

FIG. 13 shows the upper and lower retainers abutted against each otherin the mouth of a wearer.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE DISCLOSED TECHNOLOGY

A retainer with a block extending downwards from an otherwise generallyflat surface is disclosed. The block corresponds to a region of one ormore of the cuspids or pre-molars. A side block or other device on theupper retainer also abuts a wing or other abutment device of a lowerretainer causing the lower jaw to be pushed forward relative to theupper jaw and resting position (regular organic closing position) of theupper and lower jaw together. Thus, the upper teeth are pushed forwardand a space is created between the teeth behind the (lower) blockpreventing an apnea during sleep.

Embodiments of the disclosed technology will become clearer in view ofthe following description of the drawings.

References to direction (e.g. “top” or “up”, and “bottom” or “down”),for purposes of this specification refer to the direction when theretainers are worn by a person. For example, the “upper” retainer isworn above the “lower” retainer and each on the upper and lower teeth ofa person, respectively. The lower side of the upper retainer istherefore the side adjacent to the lower retainer, and the upper side ofthe lower retainer is the side adjacent to the upper retainer. Further,for purposes of this specification, descriptions of portions of theretainer refer to both the right and left sides of the retainer orperson wearing the retainer.

Discussing FIGS. 1-4 showing the upper retainer, FIG. 1 shows a lowerperspective view of an upper retainer of an embodiment of the disclosedtechnology. FIG. 2 shows a bottom plan view of the upper retainer ofFIG. 1. FIG. 3 shows a front elevation view of the upper retainer ofFIG. 1. FIG. 4 shows a rear elevation view of the upper retainer ofFIG. 1. FIG. 5 shows a side elevation view of the upper retainer ofFIG. 1. Here the upper mouth 10 has teeth 12. The teeth shown are thecentral incisor, lateral incisor, and canine of the upper jaw. A wire 20with omega loop 22 is shown connecting two sides of the retainertogether. This is what's known in the art as a “Hawley Retainer” or canbe an “Essix” retainer (vacuum formed). The materials used can be metal,plastic, or others known in the art.

Here, the lower side of the upper retainer has a generally flatelongated side which corresponds to and covers at least the molars or amolar of the upper teeth. The generally flat elongated portion of theupper retainer can cover all of the third molar, second molar, firstmolar, second bicuspid, and first bicuspid. A lower block 50 can have aflat side which is lower than the generally flat elongated portion ofthe upper retainer. This block can extend, with perpendicular orgenerally perpendicular sides, down from the generally flat elongatedportion (rest of the lower side covering the teeth) of the upperretainer to form a lowest generally flat or flat elongated side of theupper retainer. In this manner, the lower block 50 becomes the point ofcontact (on the side where the line extending from the number 50reaches) between the upper retainer and the lower retainer (to bedescribed). This leaves a space between the rest of the generally flatelongated portion 30 of the upper retainer and a lower retainer when thelower block 50 abuts a lower retainer. The lower block 50, inembodiments of the disclosed technology, corresponds to a cuspid and/orfirst bi-cuspid. That is, the lower block 50 can cover a cuspid, abi-cuspid, or both a cuspid and bi-cuspid. This means that therespective tooth is situated directly above the block 50 which iscovered by, corresponds with, and/or is adapted for covering thementioned tooth.

Referring still to the upper retainer, side blocks 32 haveright/perpendicular angles to the elongated flat region 30. The blocks32 have a flat front side (“front” being relative to the front of aperson wearing the retainer) which rises vertically or generallyvertically. The blocks 32 further have a flat or generally flat bottomside (again, relative to the direction of a standing person wearing thedevice/the body of a person wearing the device). This block, inembodiments, abuts at its front side a flange or wing extendingvertically upwards or upwards from a lower retainer.

Discussing now the lower retainer, elements of the upper retainer havebeen incremented by 100. FIG. 6 shows an upper perspective view of alower retainer of an embodiment of the disclosed technology. FIG. 7shows a top plan view of the lower retainer of FIG. 6. FIG. 8 shows afront elevation view of the lower retainer of FIG. 6. FIG. 9 shows arear elevation view of the lower retainer of FIG. 6. FIG. 10 shows aside elevation view of the lower retainer of FIG. 6. The upper blocks150 shown in FIGS. 6 and 7 are present in some embodiments; in otherembodiments, the upper blocks are lacking and the generally flatelongated upper side extends the length of the material covering theteeth from the third molar to the canine, first bi-cuspid, or secondbi-cuspid. As such, the lower block 50 of the upper retainer contactsthe generally flat elongated upper side 130 (or block 150, if present)of the lower retainer. This occurs when one bites down, pushing theupper and lower retainers against each other, whether while awake orasleep.

The lower retainer has two flanges or wings 132 in embodiments of thedisclosed technology. These wings rise at a 90 degree angle orsubstantially a 90 degree angle to the generally flat elongated side 130of the lower retainer. The rear side (relative to the position when wornby a user) of the flange 132 abuts the side block 32 of the upperretainer when worn, pushing the lower teeth forward and preventing anapnea.

FIG. 11 shows the upper and lower retainers aligned for abutment againsteach other. Here, the location of contact 51 on the top side andgenerally elongated flat region 130 of the lower retainer is marked. Thelower blocks 50 each contact a respective area of contact 51 on theupper elongated side 130 of the lower retainer. As such, in embodiments,the lower block 50 contacts and abuts the upper elongated side 130 andthe side block 32 contact and abuts at its front side, the rear side ofthe flange 132.

FIG. 12 shows the upper and lower retainers abutted against each other.Here, the lower jaw is pushed slightly forward from a natural restingposition and the upper jaw is pushed slightly back relative to the lowerjaw and a natural resting position. A space or spaced apart region 139,as shown, is formed between the upper retainer and lower retainer behindthe upper block 50. This space between the elongated sides 30 and 130corresponds to any and/or all of the teeth behind the lower block 50,such as the molars and bicuspids.

FIG. 13 shows the upper and lower retainers abutted against each otherin the mouth of a wearer. Here, the position of the upper retainerhaving an elongated region 30 and lower retainer having an elongatedregion 130 are shown. The lower side of the upper retainer is generallyflat and faces downwards, such that it is generally parallel to theupper side of the lower retainer which faces upwards with a space 55between them. This space corresponds to a space created between theupper molars 95, and 96 as well as the lower molars 195, and 196. (Notall molars are shown.) The lower teeth are pushed forward compared tothe upper teeth and a rear most point of abutment 59 is created. Thewing 132 of the lower retainer, in this embodiment, corresponds to theposition of the first 193 and second bicuspids 194 with the canine infront. The lower block 50 corresponds to the position of the firstbicuspid 94 and cuspid 93. Additional teeth (incisors, et al) arefurther shown as teeth 90, 91, 92, and 192.

While the disclosed technology has been taught with specific referenceto the above embodiments, a person having ordinary skill in the art willrecognize that changes can be made in form and detail without departingfrom the spirit and the scope of the disclosed technology. The describedembodiments are to be considered in all respects only as illustrativeand not restrictive. All changes that come within the meaning and rangeof equivalency of the claims are to be embraced within their scope.Combinations of any of the methods, systems, and devices describedhereinabove are also contemplated and within the scope of the invention.

The invention claimed is:
 1. A retainer for upper teeth comprising: left and right sides of said retainer; each left and right side of said retainer comprising two generally flat regions on a bottom side: a) a rear region adapted to cover at least molars; b) a front region adapted to cover at least said first bicuspid, said front region extending lower from said upper teeth than said rear region and wherein said rear region and said front region are separated at a vertical side of said front region which is at or generally at a right angle to said front region and said rear region.
 2. The retainer for upper teeth of claim 1, further comprising a side block, located at each said rear region, having a flat front side extending outwards from said rear region.
 3. The retainer for upper teeth of claim 1, wherein said front region has a generally flat lower surface, said generally flat lower surface forming a lowest side of said retainer for upper teeth.
 4. The retainer of claim 1 further comprising wings extending from said lower retainer towards said upper retainer adapted to abut respective side blocks on exterior sides of said upper retainer.
 5. The retainer of claim 1, further comprising a metal wire adapted to cover incisors and connect said left and right sides of said retainer. 